Debris under the flap

[Jessica Adams]

Hello to all my fellow DES friends. I am curious to know how many of you have debris under your flaps because of lasik. Could that be an additional contributor to our dry eyes? I've read how dry eye syndrome is increasing among the population and some people say it can be related to pollution and toxicity. Maybe the "metal" toxicity I have is adding up to my problem!

Just a thought

J.

[dianat]

I've not been told there is any debris under my flap. Perhaps it is undetectable??

[Jessica Adams]

My metal debris is very visible

I've been told by different ophtalmologists that in my case the metal debris under my flap is very visible due to the blade used in my operation (back 1997) which it is not used anymore. I've read in other lasik forums about people with this situation. Apparently it doesn't cause any "side effects", but who knows.

I've been reading about people that have had their metal dental fillings removed because they are allergic to them or it causes metal toxicity in their bodies (which BTW can cause dry eyes!!), I wonder if that could be my case because this debris is constituted of silicone, iron and another metal which I can't recall right now (maybe is chromium).

J

[Samantha]

Jessica,

Since the doctor can see the debris, can he/she remove it? If your eye problems are indeed caused by the debris, that might just fix it. Did you ask the doctor about the possibility of removing it? I know it's been years, the flaps are probably well healed and difficult to lift. I heard of lifting flaps that are 7 years old.

Samantha

[Rebecca Petris]

I would think that if there were toxicity issues, there would be visible inflammation at the flap interface.

Debris under the flap (including microkeratome flecks) is a cause of DLK and is sometimes treated by lifting and irrigating under the flap but that's generally limited to the early post-operative period. I'm not a doc etc etc but it doesn't seem very plausible to me that in a healed cornea many years post-op debris could be contributing in any significant way to ongoing ocular surface problems?

[shells]

Jessica,

I have debris under the flap in my left eye only. Well, debris and cells I think...but the cells are not growing, so apparently it is not a problem. I have seen a corneal specialist to get a second opinion on this, and she told me that the only way they would lift the flap is if the cells were growing which is something that I should not be concerned about at 9 months post-op. She said that any doctor who would try to lift the flap now to irrigate it out would be insane because it is much better left alone as long as it is not in my line of vision. She also said it should in no way be contributing to my dry eye.

My lasik place did not even mention the debris to me. It wasn't until I asked for a copy of my records in January that I noticed it on my charts. They had marked down "debris" under my left flap the morning after surgery, and apparently did not see the need to lift the flap and irrigate it out at that point, which I'm hoping was standard procedure, and not negligence. The second opinion definitely made me feel better about it. So, as much as I dont' like the idea of having metal debris in my eye for the rest of my life, I just need to trust the doctors on this one that it is not going to cause any further problems. Apparently it happens often and most patients probably aren't even told about it. Even if lifting the flap could get it out, I'm not sure I could be convinced of taking that step and re-severing my corneal nerves which started this whole dry eye mess in the first place!

I posted about it a while ago on LME (before I got the second opinion) and this is what Dr. G had to say:

http://www.lasermyeye.org/forums/showthread.php?t=1091

-Shelley

[Chris]

I have had a large piece of metal debris removed from under my flap three years ago. The naked eye could see the metal if a light was shined on it.

I had it removed because it was just too big and I wanted to know if it caused any of my pain. It didn't help. I have other metal too, but not quite as large.

Chris